Well instead of small frame you can always pick something else, loner seems like a good option for someone who just started, or in case he will use drugs chem reliant, its up to him. I have 5 str because of using rifles that require it (AR, FN FAL), but it shouldnt be a problem to drop it to 4 and avoid using small frame for the 1 extra ag.
About living anatomy i thought it was only + 2 damage, so thats why i didnt mention it. Its quite weird that it eats perks like mrd or 2x brd. I never thought about that perk when making burst builds.